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Medi-Cal, the nation鈥檚 largest Medicaid program, was in trouble even before the GOP鈥檚 One Big Beautiful Bill Act. Rapid expansion, spiraling costs, and billions in federal funding cuts will mean tough challenges for California鈥檚 next governor. On the campaign trail, the two men running for the job have offered few answers.
Voters in California鈥檚 22nd Congressional District call healthcare a top priority in November鈥檚 midterm elections. Although challenger Randy Villegas has built a following among residents craving change, undecided voters say they want to hear more from the Democrat and from GOP incumbent Rep. David Valadao on their affordability plans.
Ahead of Medicaid work requirements, a health plan in California hopes to stanch the number of people losing coverage by using an AI program to schedule appointments and remind enrollees to fill out paperwork. The plan says it can do the work of 40 employees at a fraction of the cost.
With the federal Medicaid work requirements looming in January, Democrats are considering state legislation to call out big companies that employ workers enrolled in the safety net health program. Business giants such as Amazon and Walmart said the figures are misleading.
Republicans say California鈥檚 use of Medicaid money for social services amounts to waste, fraud, and abuse. But even as Gov. Gavin Newsom voices concern about losing funding, he says he鈥檚 proud of the state鈥檚 holistic approach to caring for its sickest and most expensive patients.
California鈥檚 next governor will face tough decisions on a highly controversial piece of healthcare policy: what to do about health coverage for the more than 1.4 million low-income residents without legal status. Democrat Xavier Becerra and Republican Steve Hilton present starkly different choices as public opinion wavers.
Hundreds of hospitals nationwide are bracing for Medicaid cuts as a result of the One Big Beautiful Bill Act. Some state lawmakers are eyeing loans and other forms of financial aid to distressed hospitals in rural and urban areas, as healthcare providers warn of cuts to critical services and scramble for funding.
California Gov. Gavin Newsom, who campaigned on single-payer, has called healthcare a human right. In practice, however, the potential presidential candidate emphasizes safety net services, from expanding coverage to immigrants to constructing behavioral health supports, often for those experiencing homelessness.
A 吃瓜不打烊 analysis found Medi-Cal lost almost 100,000 immigrants without legal status in the second half of 2025. California officials say it鈥檚 not clear if immigrants are losing coverage faster than other populations, but researchers said the most obvious driver is fear of the Trump administration鈥檚 immigration policies.
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Trump administration officials say the state allows rampant fraud and have promised to investigate, blaming the 鈥淩ussian, Armenian mafia鈥 in the hospice and home health care industry. But data shows hotbeds of health care fraud throughout the country, with California outperforming most other states in recovering fraud dollars.
Progressives are assailing Gov. Gavin Newsom for proposing to pull back coverage for some legal residents, such as refugees and asylum-seekers, while conservatives lambaste the California Democrat for using limited state funds on Medicaid coverage for immigrants without legal status.
Martha Santana-Chin, a daughter of Mexican immigrants, last year took the helm of L.A. Care, the nation鈥檚 largest publicly operated health plan. She warns that looming federal cuts will push up to 650,000 people off L.A. Care鈥檚 Medicaid rolls by the end of 2028.
Programs like Jamboree Housing Corp. have leveraged Medi-Cal funding to offer residents access to social services that experts say are key to keeping them off the streets. California intends to keep it that way, despite federal cuts.
Low-income Californians who use Wegovy and similar medications for weight loss lost their coverage at the start of the new year, with officials advising diet and exercise instead. California and other states say the drugs are too costly, even as the Trump administration announces plans to lower prices.
Even as President Donald Trump and GOP lawmakers say the One Big Beautiful Bill Act targets waste, fraud, and abuse, Medicaid health plans are hosting events across the U.S. to prevent low-income families from losing health insurance and food benefits next year.
During a California gubernatorial debate, candidates promised to protect people鈥檚 access to health care and fight back against Trump administration cuts. With the contest a year away, polling shows voters want the next governor to minimize out-of-pocket health care costs, increase mental health care, and expand caregiving services.
In a rural, largely Republican region of California, homegrown efforts to bolster the medical workforce face an uphill battle, in part because of federal health care cuts approved by the GOP Congress and signed by President Donald Trump in July, as well as a state budget deficit.
A statewide initiative to formalize the role of community health workers and expand their ranks was meant to improve the health of underserved communities, particularly Hispanic populations, who often experience higher rates of chronic illnesses. But years in, California has abandoned a certification program and rescinded public support.
Immigrants without legal status who live in the state are facing a Medi-Cal enrollment freeze next year. But the spate of immigration raids has raised fears that signing up before the deadline will put them on the radar of federal officials.
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